The present invention relates to the field of arthroscopic surgery, particularly anterior cruciate ligament reconstruction.
One common approach to cruciate ligament reconstruction is the use of the patellar tendon to form a bone-tendon-bone graft. This involves cutting out a bone block from the top of the patella. Deviations from proper technique for removal of the patellar bone block have resulted in reports of patellar tendinitis, patellar fractures and even, in some instances, ruptures of the patellar ligament after the grafting procedure. Whether or not these complaints are properly related to the use of the patellar bone block in cruciate ligament reconstruction, these concerns are reason enough to identify an alternate method for performing the surgery.
Cruciate ligament reconstruction involves the drilling of a tunnel through the tibia and into the femur. The tunnels are used for insertion of a graft to replace the damaged cruciate ligament. The accuracy in drilling these tunnels is critical to providing a satisfactory repair. A commonly used method of directing a drill to form these tunnels is by using a guide wire drilled through the bone first. The location of the guide wire can be tested before drilling out the tunnel. A cannulated drill is then inserted over the guide wire to drill the full size tunnel. When it has been desirable to retain the core of the bone tunnel being drilled, a coring reamer is used. However, when a coring reamer is used over a guide wire, the guide wire produces a stress riser in the bone core. Moreover, the use of a guide wire is generally inadequate to accurately guide a coring reamer throughout the drilling of an entire bone tunnel.